Quality of life improves after palliative placement of percutaneous tunneled drainage catheter for refractory ascites in prospective study of patients with end-stage cancer Journal Article


Authors: Robson, P.; Gonen, M.; Ni, A.; Brody, L.; Brown, K. T.; Getrajdman, G.; Thom, B.; Kline, N.; Covey, A.
Article Title: Quality of life improves after palliative placement of percutaneous tunneled drainage catheter for refractory ascites in prospective study of patients with end-stage cancer
Abstract: Objective Percutaneous tunneled drainage catheter (PTDC) placement is a palliative alternative to serial paracenteses in patients with end-stage cancer and refractory ascites. The impact of PTDC on quality of life (QoL) and long-Term outcomes has not been prospectively described. The objective was to evaluate changes in QoL after PTDC.Method Eligible adult patients with end-stage cancer undergoing PTDC placement for refractory ascites completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and McGill Quality of Life instruments before PTDC placement and at 2 to 7 days and 2 to 4 weeks after PTDC. Catheter function, complications, and laboratory values were assessed. Analysis of QoL data was evaluated with a stratified Wilcoxon signed-rank test.Result Fifty patients enrolled. Survey completion ranged from 65% to 100% (median 88%) across timepoints. All patients had a Tenckhoff catheter, with 98% technical success. Median survival after PTDC was 38 days (95% confidence interval = 32, 57 days). European Organization for Research and Treatment of Cancer scores showed improvement in global QoL (p = 0.03) at 1 week postprocedure (PP). Significant symptom improvement was reported for fatigue, nausea/vomiting, pain, dyspnea, insomnia, and appetite at 1 week PP and was sustained at 3 weeks PP for dyspnea (p < 0.01), insomnia (p < 0.01), and appetite loss (p = 0.03). McGill Quality of Life demonstrated overall QoL improvement at 1 (p = 0.03) and 3 weeks (p = 0.04) PP. Decline in sodium and albumin values pre-and post-PTDC slowed significantly (albumin slope-0.43 to-0.26, p = 0.055; sodium slope-2.50 to 1.31, p = 0.04). Creatinine values increased at an accelerated pace post-PTDC (0.040 to 0.21, p < 0.01). Thirty-eight catheter-related complications occurred in 24 of 45 patients (53%).Significance of results QoL and symptoms improved after PTDC placement for refractory ascites in patients with end-stage malignancy. Decline in sodium and albumin values slowed postplacement. This study supports the use of a PTDC for palliation of refractory ascites in cancer patients. © Copyright Cambridge University Press 2019.
Keywords: quality of life; end-stage cancer; key wordsmalignant ascites; percutaneous drainage catheter
Journal Title: Palliative and Supportive Care
Volume: 17
Issue: 6
ISSN: 1478-9515
Publisher: Cambridge University Press  
Date Published: 2019-12-01
Start Page: 677
End Page: 685
Language: English
DOI: 10.1017/s1478951519000051
PUBMED: 30880658
PROVIDER: scopus
PMCID: PMC6829044
DOI/URL:
Notes: Nancy Kline listed in dedication following her death, was not at MSK -- Source: Scopus
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MSK Authors
  1. Mithat Gonen
    824 Gonen
  2. Anne Covey
    146 Covey
  3. Lynn Brody
    110 Brody
  4. Karen T Brown
    173 Brown
  5. Piera M Cote Robson
    7 Robson
  6. Bridgette Helen Claire Thom
    61 Thom
  7. Ai   Ni
    95 Ni